Whether you are first-time parents or not; whether you want a VBAC; whether you are a single-mum, an “old” mum, an IVF mum; whether you want your birth at home or hospital – whatever your circumstances or preferences, you will be pleased you did this workshop.

What better way to start heading towards your empowered birth, and to start growing your “village” with other like-minded people? As the old African proverb says “It takes a village to raise a child.”

The full price of the workshop is £130. The deposit of £30 payable online when you book your space. The balance to be paid at least 7 days before the event.

Did anyone see Horizon on BBC 2 last Monday, the 17th February? It’s still on iplayer so I urge you to watch if it you can. The headline is Placebo, but it’s much more than that, it teaches us about the power of suggestion. Something us hypnotherapists have known about for years.

A placebo is a suggestion. You are told something will make you better, so you believe that you are being offered a drug or vitamins that will improve your situation in some way. There is overwhelming evidence that demonstrates, in different ways, how when you think you are getting better, improving physical performance, reducing pain with an intervention, or even taking a drug you know to be a placebo, your body makes actual physical changes in line with the suggestion of what that placebo is meant to do.

The chemistry in your brain changes, just because of how you think!

This means that if I were to give you a drug and tell you that it would get rid of morning sickness, but it was in fact a capsule filled with cornflour, you would more than likely see an improvement in your morning sickness. This is not to say that you aren’t experiencing morning sickness and it’s all in your mind, what it shows is that if you are experiencing it your brain is able to make adjustments to the chemistry in your body that reduce that feeling of nausea.

Even more interesting is the power of ‘nocebo’. If I were running a randomised drug trail I would have to tell you about the side effects of the drug you were receiving even if you were receiving the placebo. Research shows that this suggestion also causes chemical changes in the brain, and that people receiving a placebo experience the side effects of the real drug. You can read a lot more about this in Prof Irving Kirsch’s book ”The Emperor’s New Drugs”. Kirsch used Freedom of Information to extract trials from drug companies that hadn’t been published and he dissected them, particularly in relation to antidepressants. This was the book that really helped me get to grips with the extent to which the effects of placebo were understood but hidden from us.

The programme also talked about the role of expectation in the experience of pain. If I were to tell you that something is painful, you will be more likely to experience pain even if there is none. Evidence now also shows that how we think about pain, actually can overpower strong opiate drugs such as remifentanyl, which in some hospitals is offered through an iv in labour. When receiving a positive suggestion, the front part of the brain becomes more active. As an area associated with endogenous pain modulatory system, including the anterior cingulate cortex, which releases dopamine and your body’s own natural opoids. If you are given a negative suggestion of pain or of side effects, it activates the area of your brain more associated anxiety and the increased levels of pain, the hippocampus, in particular the amygdala. You can read more about expectation and pain here.

Pretty amazing, I think. So how does this type of suggestion relate to birth? A great deal and sadly it’s completely under explored, trials that are set up rarely take account of the nature of hypnosis, suggestion and the subtleties of how it works, but I’ll talk about that in another blog.

First of all if you are told to expect pain, you are likely to trigger activity in the hippocampus and amygdala during birth, the part of your brain associated with anxiety and increased levels of pain. This is also known as your limbic system.

On the other hand, imagine that you have been given the positive suggestion by your doctor or midwife that birth is completely normal, that it’s perfectly manageable; perhaps society around you told you it was just an intense pressure and it didn’t last long. Or you were given a drug during labour and told it was an epidural, even though it wasn’t, what would happen? I know anesthetists that have said on siting an epidural, but not administering it, women say, “oh that’s so much better, oh that’s wonderful thank you”. I know many midwives who agree that women ring or come in complaining of stomach upset; when they are examined and told they are in active labour, their pain suddenly goes through the roof, ‘they can’t cope’ or ‘they need and epidural’.

Placebos, have given us insight into the profound changes our beliefs and expectations can make in the chemistry of our brain. Hypnosis is a vehicle where we can ethically use the power of suggestion with the full knowledge of our clients.

Preparing for birth using hypnosis, makes absolute sense, it is based on genuine contemporary research around expectation, belief and the extraordinary power of our minds to alter our experience in each and every moment.

You can read more about the power of suggestion, placebo and pain in my book ‘Mindful Hypnobirthing’ and by attending one of our Mindful Mamma classes, which show you how you can use hypnosis to create a positive experience of birth.

Placebo, and how it can change your experience of pain and birth

Did anyone see Horizon on BBC 2 last Monday, the 17th February? It’s still on iplayer so I urge you to watch if it you can. The headline is Placebo, but it’s much more than that, it teaches us about the power of suggestion. Something us hypnotherapists have known about for years.

A placebo is a suggestion. You are told something will make you better, so you believe that you are being offered a drug or vitamins that will improve your situation in some way. There is overwhelming evidence that demonstrates, in different ways, how when you think you are getting better, whether that be improving physical performance, reducing pain with an intervention, or even taking a drug you know to be a placebo, your body makes actual physical changes in line with the suggestion of what that placebo is meant to do.

The chemistry in your brain changes, just because of how you think! Placebos, have given us insight into the profound changes our beliefs and expectations can make in the chemistry of our brain.

This means that if I were to give you a drug and tell you that it would get rid of morning sickness, but it was in fact a capsule filled with cornflour, you would more than likely see an improvement in your morning sickness. This is not to say that you aren’t experiencing morning sickness and it’s all in your mind, what it shows is that if you are experiencing it, your brain is able to make adjustments to the chemistry in your body that reduce that feeling of nausea. Purely on the suggestion that it can.

What happens if you give a negative suggestion?

Even more interesting is the power of ‘nocebo’. If I were running a randomised drug trail I would have to tell you about the side effects of the drug you were receiving, even if you were receiving the placebo. Research shows that this suggestion also causes chemical changes in the brain, and that people receiving a placebo experience the side effects of the real drug. This is called nocebo. You can read a lot more about this in Prof Irving Kirsch’s book ‘The Emperor’s New Drugs”. Kirsch used Freedom of Information to extract trials from drug companies that hadn’t been published and he dissected them, particularly in relation to antidepressants. This was the book that really helped me get to grips with the extent to which the effects of placebo were understood but hidden from us.

The role of expectation and suggestion.

The programme also talked about the role of expectation in the experience of pain. If I were to tell you that something is painful, you will be more likely to experience pain even if there is none. Evidence now also shows that how we think about pain, actually can overpower strong opiate drugs such as remifentanyl, which in some hospitals is offered through an IV in labour. In a study by Irene Tracey (2011) she was able to demonstrate that if the volunteers in the experiment were told that the pain would increase because the pain killer was being removed, the pain did increase, even though the pain killer was still being administered in the same dose as before. Yet if they were told that they were being given the pain relief even when they were not, they felt less pain and the front part of the brain became more active. This is an area associated with endogenous pain modulatory system, including the anterior cingulate cortex, which releases dopamine and your body’s own natural opoids. On the other hand, if you are given a negative suggestion around pain, or of side effects, it activates the area of your brain more associated with anxiety and increased levels of pain, the hippocampus, in particular the amygdala. You can read more about expectation and pain here.

Pretty amazing, I think.

So what has placebo this got to do with birth?

So how does this type of suggestion relate to birth? A great deal and sadly it’s completely under explored, trials that are set up to explore the role hypnosis can play in birth preparation, rarely take account of the nature of hypnosis, suggestion and the subtleties of how it works, but I’ll talk about that in another blog.

“You are going to feel better when you take this pill”

First of all if you are told to expect pain, you are likely to trigger activity in the hippocampus and amygdala during birth, the part of your brain associated with anxiety and increased levels of pain. This is also known as your limbic system.

Placebo and positive suggestion.

On the other hand, imagine that you have been given the positive suggestion by your doctor or midwife that birth is completely normal, that it’s perfectly manageable; perhaps messages from the society around you tell you that it’s just an intense pressure and it didn’t last long. Or you were given a drug during labour and told it was an epidural, even though it wasn’t, what would happen? I know anesthetists that have said on siting an epidural, but not administering it, women say, “oh that’s so much better, oh that’s wonderful thank you”, assuming that the epidural has gone in and is working. I know many midwives who agree that women ring up or come in complaining of stomach upset; when they are examined and told they are in active labour, their pain suddenly goes through the roof, ‘they can’t cope’ or ‘they need an epidural’.

What role does hypnotherapy play in placebo and birth?

Hypnosis is a vehicle by which we can ethically use the power of suggestion with the full knowledge of our clients. Brain activity measured while people are in hypnosis and receiving a pain stimulus shows that a different part of their brain is activated during a state of hypnosis, decreasing sensations of pain. In fact, the Horizon programme showed someone who was prepared for, and underwent, a wisdom tooth extraction using hypnosis.

Preparing for birth using hypnosis, makes absolute sense, it is based on genuine contemporary research around expectation, belief and the extraordinary power of our minds to alter our experience in each and every moment. When you take a class you lean about this research, you learn how to harness the power of suggestion, to make subtle changes in your birth preferences that shift how suggestions can be made to you, as well as powerful techniques which reduce activity in the amygdala (mindfulness) and increase activity in the area of your brain which triggers your own natural painkillers (hypnosis).

You can read more about the power of suggestion, placebo and pain in my new book ‘Mindful Hypnobirthing’ and by attending one of our Mindful Mamma classes, which show you how you can use hypnosis to create a positive experience of birth.

If you are interested in the power of our minds to change how our bodies react you can also read David R Hamilton’s ‘How your Mind Can Heal Your Body’ which includes lots of evidence based information on how placebo works.

Prof Irving Kirsch’s book ‘The Emperor’s New Drugs‘, is fascinating and shows how his project to release drug trial information under Freedom of Information, exposed how powerful the placebo was.

If you know of any other interesting reads or blogs I would be very interested to know of them, so please post them below.

Each day this week, I’m tackling #birthfears. One of those which comes up time and time again, is pain and birth. The issues around pain and birth are complex and not just physical but also psychological. In this blog I can only scratch the surface but I hope that it will start you thinking about fear and expectation in relation to pain.

Thinking positively about pain and birth

Today I’m going to talk about the P word. Yes I am going to write it, “pain’. Some hypnobirthing models don’t mention the word as the mere suggestion of it creates an expectation of it. Although it’s true that suggestion is very powerful, just because I don’t mention the word pain doesn’t mean that your friends, television, radio, or even your midwife will use the word without fail in relation to birth.

It’s important to be upfront about the word and about what pain actually is and why women experience it when they give birth. But haven’t you always wondered why some women have an easy time of it, while others complain of the worst pain ever experienced? It’s not coincidence; think carefully about your friends that have had an easier time of it, perhaps they are your friends that are more laid back generally in life, more relaxed. Perhaps the friends that experienced more pain are generally more anxious, wanting to be in control more.

Anxiety can create tension and increase pain

If you are starting to categorise yourself as an anxious person, relax; hypnosis and mindfulness can help you to shift that mindset. But first before you start analyzing yourself, I want to draw your attention to what anxiety does. Whether it’s birth, back pain, or arthritis, anxiety is known to increase levels of pain. When our muscles are relaxed they work harmoniously, when they are tense they create pain. During birth we are not meant to feel intense pain, pain is a signal from our body that something is wrong. There is all sorts of research emerging at the moment about our physiology and our pain/pleasure centres in the brain that is beginning to support this hypotheses.

Our uterine muscles are meant to be relaxed, this way they work harmoniously. When we are free of anxiety or fear, our bodies are designed to produced hormones that make us drowsy, spaced out and which can make birth, for some women, an ecstatic experience. When these muscles are working, it’s a powerful and intense sensation; these sensations have a role and help guide how we move during labour to help our babies be born.

Ahhh did you see that, I used the word sensation, instead of pain. This is because of the second rule of pain – expectation. If we expect pain, and are focused on it we are likely to experience it, even when it’s not there. This is not to say it’s a phantom pain, and I’m not going to say that someone who has severe chronic back pain isn’t experiencing it, they do, but it comes from the brain not in their back where they think it is. It’s as if the original injury has been hardwired into the brain. If you want to learn more about this read this fantastic little book by Dr Grahame Brown.

Expectation of pain creates pain.

I’m fascinated about suggestion and expectation of pain, I think it’s extraordinary and the most misunderstood parts of our physiology/psychology.

A study that came out in 2011 by Prof Irene Tracy shows this rule of expectation and, with MRI added to the mix, is really starting to open our eyes to what our brains are capable of.

This study in this took 27 volunteers and placed them in an MRI. They were each given an IV to administer a strong opioid anesthetic. Before the experiment started they had a control run where heat was applied to their leg until it reached 70, on a scale of 1-100, and they were given an IV line. Then, unknown to the participants, the team started to give the drug to see what the effects were when the participants didn’t know they were getting the drug. The average pain rating when down from 66 to 55. Then the participants were told they were getting the drug, but there was no change in the amount, the pain rating dropped to 39!

Now this is the interesting part, the people volunteering were led to believe that the drug had been stopped and told, that means given the suggestion, that ‘there may be a possible increase in pain’, the drug was still being administered with no change. Their pain intensity increased to 64 close to the original pain level of 66 which was without drugs. Even more remarkable the MRI showed that the brains in the volunteers showed that their pain networks responded to their expectations and the suggestion at each stage.

These volunteers were told that they ‘may expect an increase in pain’. What must it be like for pregnant women who are bombarded with messages that birth is so painful that we are primed to forget it so we’ll have more? Their expectation is unquestionably focused on pain. The midwife may say things like “how far apart are your pains’, or ‘do you want pain relief’, ‘where are you feeling the pain’, this gives the suggestion of pain during labour as well.

So why don’t some women feel pain during birth?

I’ve heard women describe birth as intense and powerful, I’d heard the word ‘hurtment’offered up by one woman, other said that there is not a word in the dictionary to describe what the experience is. I’ve heard women who were terrified of the pain before, turn to me and say “I can do this” half way through their labour when they realise that actually the horror stories were wrong.

Of course these women feel something, they are aware of the intensity, and power of birth, but they don’t call it pain. They may call it energy or sensation, or tightening. By changing its name you can change the experience but you also take the power back to yourself. If I were to say to you, you will feel a very strong squeezing or tightening during each contraction, it changes how you feel about it. It feels better, achievable, less frightening. You can decide how you wish to experience it, the sensation of birth is not foreign to you, it doesn’t invade you, it come from within you.

How can I turn the ow into wow?

Begin to change how you see birth, start to see it as a powerful experience, a welcome experience. Hypnosis is brilliant as accessing your deep-rooted fears around pain of birth and changing them into a positive expectation. You can read more about hypnosis for birth here. It also gives you techniques that help activate the part of your brain which can change and reduce those sensations during birth. If you do experience pain, sometimes certain interventions or anxieties can arise which case tension and pain, hypnosis is great at being able to turn them off or down. Read this amazing article by Dr John Butler who had a hernia operation using self-hypnosis.

Here are some tips

First tackle your fears of pain, these may be creating unnecessary anxiety. Perhaps this may be learning about the physiology, reading books that explore birth in a very positive way. Try ‘Ina May’s Guide to Childbirth’ or read my new book coming out in March ‘Mindful Hypnobirthing’ where I explore our physiology and psychology around birth, fear, expectation and pain in much more depth.

Learn techniques such as massage, which are wonderful for relaxing your muscles during labour

Stop listening to people telling you about painful births, talk to people who are likely to say ‘you know what, it was ok, in fact it was better than ok’.

Stop watching dramatic TV shows about birth, these create expectation

Think about creating a birth environment that will relax and calm your rather then make you anxious and frightened.

Affirmations

Say these affirmations every day, to yourself and then out loud as you get more comfortable. Affirmations are a very simple way of beginning to change your unconscious belief around pain, expectation and birth.

As my body expands and grows I welcome each tweak and niggle as a sign of my baby growing and my body creating the perfect environment for pregnancy

When labour starts I relax and let go, excited that I will soon be holding my baby in my arms

As the contractions rise and fall in my body, I embrace that sensation resting comfortably between each one

As I rest between each one, I feel a sense of deep relaxation and closeness with my baby and my partner

I am comfortably aware of the sensations of labour as they get stronger and longer bringing my baby to me

I see my contractions positively and with each tightening I follow my breath

As I focus and follow on my breath my body relaxes into each contraction

Can you really have a pain free labour?

by Sophie Fletcher

Many years ago I met a friend of my husband who was 24 and had a 10 year old daughter. The story goes that her mum phoned her dad in the pub and asked him to come home because Anna was having a baby. He replied “I’ll finish my pint and I’ll come home and we’ll sit down and discuss what we are going to do”. Then her mother shouted “ now, she’s having the baby now”. Anna gave birth to her little girl within the next couple of hours, with little more than a bit of stomach ache and sitting on the loo. So apart from thinking she had a bit of an upset tummy, she was fine. I thought “how on earth could someone be pregnant and not know and is that what you would call a pain free labour?”.

When I became pregnant I was in very good shape, it was just after I got married and had spent months toning and exercising to squeeze into my dress. Throughout my pregnancy I had intermittent bleeding, I had no morning sickness at all, and I didn’t show until very late on in my pregnancy. In fact I recall at 24 weeks, putting on my new Isabella Oliver trousers on the tightest setting to go to work and then proudly sticking my tiny rounded tummy out. When I did go into labour early my ‘tiny bump’ was commented on. I’m sure if I had been on birth control and not planning a family that being pregnant would have been the last thing I’d have thought of. In my years of teaching I have seen women with very very small bumps, and women with huge bumps. Conversely a friend of mine who definitely isn’t pregnant has IBS and is always complaining she looks pregnant, another has fibroids and her abdomen can get quite swollen.

I can see how possible it could be years before pregnancy tests, or even today if you are taking precautions that have failed. It’s rare but it happens. When researching this, I stumbled across a show that is running in the US called “I didn’t know I was pregnant”. If you want to see it, google it, it’s full of Discovery Health drama so I won’t post it, but you can read this very funny critique of it here. How could I have not known about this show!

What really interested me is how women who don’t know they are pregnant experience having a baby, do they have what would be considered a pain free labour? There are many antenatal classes today that focus on the aspect of fear and expectation; the ideology that when we are pregnant, we become anxious of labour which creates physical tension, which in turn make birth much more painful than nature intended it to be. Some hypnobirthing models avoid the word pain altogether and say birth isn’t meant to be painful. It’s certainly true that expectation of pain, whatever that pain is, increases our perception of the intensity of that pain. Prof Irene Tracey at Cambridge University has undertaken some significant work on expectations of pain and in a recent study examined how manipulating participants’ expectations of pain can influence their response to an active drug. So in theory if you aren’t expecting to give birth, you don’t have the same level of expectation could you have a pain free labour.

A study published last year by her, showed that volunteer’s experience was influenced not by the drug but whether they were told the drug had or had not been administered. This showed the volunteers really did experience different levels of pain when their expectations were changed, although the administration of pain relief remained constant.

I’ve heard an anesthetist say that he frequently goes to administer a epidural, he may put pressure on the area, insert the needle and ask “how is that”, for the mum to say “oh thank you that’s fantastic such a relief” before he’s actually put the drug in. I heard mums ask if their partner can put the tens machine up, only to get relief before the partner has turned it up.

The power of hypnosis is also undeniably a brilliant pain management tool. Suggestions used during hypnosis distract the mind through disassociation, but also embed the belief that everything is well and fine and that the more they let go the more comfortable they are, and the more comfortable they are the easier it is to let go. Effectively reducing the expectation of pain. As a hypnotherapist in my general practice, I often work with people who have chronic pain; their pain is constant and yet when they are under hypnosis the pain disappears, and remains much less even after the session has finished. To read an extreme example of how hypnosis can manage physical sensation and pain read this article by Dr John Butler on his own hernia operation using hypnosis.

As a doula I use deep hypnosis for women, that are in a long latent stage, to get rest. After a short session of hypnosis people generally feel energized so it’s a great way of helping to manage this. Recently a client who had had an epidural with her first birth said that it was amazing and as effective as the epidural, she said during the deep hypnosis she went from having a labour with pain, to it being a pain free labour.

Expectation of pain during labour can create tension, which can create pain. However there is no denying that labour can trigger sensations for some women, sometimes powerful sensations, similar to stomach aches. This can be unexpected for women who are taught that strong sensations aren’t a part of labour. If we are not prepared for the sensation of labour, our brains then fall back to default position and perceive it as pain, rather as pressure, tightening or aches.

Women who don’t know they are pregnant don’t build up that expectation of pain in labour. Even if they are in unconscious denial of pregnancy they will avoid reading up, or listening to pregnancy related horror stories.

So I googled for stories, and found that as well as the show in America on the subject, a surprising amount of stories demonstrated consistencies in how women experienced the unexpected birth of a child.

This one from Leanne Carter, who felt a bit bloated before Christmas, but was still having her periods and had no other symptoms. She did experience stomach cramps but thought they were period pains, when they got bad (probably transition) they took her to hospital where she took herself off to the loo and felt the urge to push, her baby boy was born shortly after.

Another girl, a student, again thought she had bad period pains, eventually went to hospital where they discovered she was pregnant, assumed she was 32 weeks, hooked her up to an ECG, she unhooked herself as she needed the loo. As she tried to go for a poo, things didn’t feel quite right and she reached down and could feel the top of her baby’s head. She said “a few pushes later and I had given birth. Amazingly I felt calm and focused. My oft potty mouth was expletive free. The only words I spoke were ‘I don’t need to’ when my friend told me I could make a noise”.

Someone worked a night shift in a hospital, stuck it out till she finished at 9am, went to A and E because of abdominal pains and a baby arrived just before lunchtime.

A young teenager had played a hockey match and then thought that she had a bit of stomach upset. Baby arrived a couple of hours later.

From all the stories I encountered there were consistencies on a number of things, the women complained of a stomach ache or feeling out of sorts, or back ache, but just put it down to other symptoms, went to lie down or managed in the same way they would a headache or flu. If the sensations got troublesome, usually only a short while before their baby was born, they took themselves to A&E. This is likely to be transition and that natural short surge of adrenaline just before baby is born. Without exception they all seemed to have very short labours simply because they treated it as they would a virus or stomach bug until the last moments before the baby was born.

The internet is awash with forums trying to second guess when a woman is going into labour, in many ways we are over educated and women are much more alert to the signs of their body warming up, thereby often assuming labour was longer than it was. For some women attention turns almost obsessively to those small indictors of labour being closer and the mind becomes focussed on every minute change, often exaggerating signs. On the other hand, it’s not uncommon for very laid back mums to carry on with everyday tasks until they are no longer able and baby’s arrival is imminent.

I’d be really interested to hear your thoughts or stories of finding out you were pregnant very late on in your pregnancy, or anecdotal stories from your parents or grandparents. Especially if you felt you had a pain free labour. I’m sure there are plenty more out there!

Not so long ago, new born babies were operated on without anaesthetic, because it was believed that their brains were too immature to register pain. They were slapped, hung upside down, rubbed vigorously with rough towels, and more. Nowadays, we know that babies feel pain, and that they remember birth. They are beings right from the start. Science is now beginning to explore this rich arena. It seems that babies are communicating as soon as they enter our world of light, air and gravity. Our sociability is with us from the beginning. When watching the birth videos in class (and of course, I have watched them quite a lot!) I notice more and more that the babies’ cries are communicating. How do I know? Because their cries change. I can hear the increase in crying when a voice in the room becomes raised. I can hear the “sniffling” of a baby beginning to feel soothed when in mum’s arms. Knowing you can soothe your baby is a wonderful feeling for a mum and dad. Seeing your baby suffer is a horrible feeling for a mum and dad. As HypnoBirthing has always said, nature guides us. She ensures that what feels right, is indeed right. So, as a new mum and dad, you have authority and permission to ensure that your baby’s cry is heard, and that you can begin to listen and soothe your baby as soon as he enters your world.

Mindful Hypnobirthing is a bestselling book on hypnosis and mindfulness for birth. Written by Sophie Fletcher one of the UK's leading hypnotherapists for pregnancy and birth, it will help you to prepare your mind and your body for a positive experience of birth.

The downloads on this site are written and recorded by Sophie and are designed to be flexible. Whether you are doing hypnobirthing or wanting to try out some relaxation for pregnancy you will find something here for you.

If you have bought the book you can download the mp3s from the publishers website mindful-hypnobirthing.co.uk or by contacting us directly.

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Mindful Mamma hypnobirthing is the orignal one day Mindful Hypnobirthing™ class. It is based on the most up to date research and is constantly evolving to include simple techniques that reflect this. It is unlike any other hypnobirthing class, it’s not just relaxation but powerful hypnosis and mindfulness taught by the best. We are the first class to combine mindfulness with hypnobirthing and you’ll learn practical mindful hypnobirthing techniques to help you feel more relaxed and in control on the day. Whatever birth you choose to have, the day you welcome your baby into your arms for the first time should be a fulfilling, and memorable experience.